My Greatest Teachers Weren't MDs

Important lessons med school didn't teach me

As I reflect on my clinical training, my memory is full of people I've met in and since medical school. Experiences with them propelled my learning, enriched my understanding of the practice of medicine, and gave me an appreciation for life and health.

If I met them today, I would be embarrassed by memories of my former self adjusting to the clinical world. With some, it would be a tense reunion -- like meeting an ex -- with painful moments resurfacing. And with others, it would be sweet.

Some days I wish I could talk to them again -- not as their doctor, but from one human being to another.

What would I say to the man I met only weeks into my clerkships? "Hi, sir, remember me? Yeah, I'm that medical student from the clinic. You were expecting me to tell you that a carotid endarterectomy would reverse your stroke. I didn't. Remember how you cried? I didn't know what to do, other than give you a tissue. I wish the setting had been better. I wish the attending had more time to spend with you. I wish someone had explained it to you sooner."

Or for the patient with the neck wound. "I'm so sorry for the pain you experienced when I fumbled around with that staple remover. I wish you understood the time crunch on the residents who left this simple task to me. They probably would have done a better job and caused you less pain. But you know what? The next time I did it, it was painless."

And what about the woman my age, who could have been my classmate? "I could tell how hesitant you were that day. A male doctor and a male medical student. Sure, we had a chaperone, but she wasn't the one performing the intimate examination. Your face exclaimed that you wished it was a female physician doing the exam. I just followed directions, but maybe I should have asked what your preference was first."

All of these sound incomplete. It's not that I feel a deep guilt and a need to apologize for any malicious intent. Rather, it is an acknowledgment of the growth that occurred, growth that is necessary but comes at a cost. Their cost.

Perhaps, more of what I mean to say is what I would say to the man I met in cardiology. "When we came by to round on you, you were already gone. Eventually, we found you, over in the ICU. I don't think you noticed us when we first arrived, you were absorbed in spoon-feeding your wife ice chips. I paused in the hall before coming in. I wanted to remember that moment."

To those who have been my best teachers, and inspire me every day, thank you.

Andrew Perry, MD, is a resident physician at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. He also produces a podcast on issues in cardiology for MedPage Today.

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